Study: Surgical Gloves Before Surgical Gown Decreases Infection Risk

A study conducted by members of Duke University Medical Center's Department of Orthopaedic Surgery showed that putting on surgical gloves before putting on a surgical gown has a significant impact on sleeve contamination.

The study, which was published in The Journal of Arthroplasty, compared the differences in gown contamination between three different gown and glove donning techniques. The participants — Duke surgeons of varying experience levels — covered their hands with ultraviolet light disclosing lotion and then put on surgical gown and gloves using their preferred technique and the proposed technique in a randomly assigned order. Gowns were removed and analyzed under ultraviolet light for distance and quantity of sleeve contamination.

The finding: Gloving first demonstrated zero contamination in all samples, which researchers said was significantly less than both closed and open staff-assisted techniques.

The researchers' conclusions include the following: "We strongly recommend considering the use of this glove and gown donning technique as opposed to the currently accepted closed and open techniques in an effort to reduce gown contamination."

Speaking to Orthopedics This Week, Colin Penrose, MD, Duke University Medical Center orthopedic surgery resident and co-author, said, "Something so simple as putting on gloves, and it is easy to learn this new technique, could potentially have a significant positive impact on the surgical outcome."

Study: MRSA Infection Risk Greatly Reduced By Home Decolonization

The results of a new study indicate that decolonization efforts at home can significantly reduce the likelihood of infection for hospitalized patients harboring methicillin-resistant Staphylococcus aureus (MRSA).

A trial — called "Changing Lives by Eradicating Antibiotic Resistance (CLEAR) — randomly divided more than 2,100 adult hospital patients with colonized MRSA into one of two groups. One group received post-discharge hygiene education. The other received this education plus a decolonization protocol. Decolonization involved the use of chlorhexidine mouthwash; baths or showers with chlorhexidine; and nasal mupirocin by patients for five days repeated twice per month over six months. Participants were followed for 12 months following discharge.

Among the findings of the study, which was published in the New England Journal of Medicine: The decolonization group experienced 30% fewer MRSA infections and 17% fewer infections of any kind. Decolonization group patients who fully adhered to the regimen (i.e., did not miss any decolonization doses) experienced 44% fewer MRSA infections and 40% fewer infections overall.

As a press release noted, the Centers for Disease Control and Prevention (CDC) has shown that MRSA carriers discharged from hospitals are at high risk of serious disease from MRSA in the year following their discharge. Approximately 5-10% of hospitalized patients are MRSA carriers.

In the release, Dr. Mary Hayden, professor of internal medicine and pathology, chief of the division of infectious diseases and director of the division of clinical microbiology at Rush University Medical Center, said, "Our goal was to understand whether removing MRSA from the skin, nose and throat was better than hygiene education alone in reducing MRSA or other infections and associated hospitalizations. … With an issue this large, we wanted to find best practice strategies to prevent these infections and associated hospitalizations. This large clinical trial helped determine that there is a way to help prevent infections after patients go home and it can prevent readmission."

Study: Hospital Sinks Next to Patient Toilets May Harbor Dangerous Bacteria

A new study has found that sinks located next to patient toilets in hospital rooms are far more likely to harbor dangerous bacteria than those sinks located closer to the room's entry door, according to an Association for Professionals in Infection Control and Epidemiology (APIC) news release.

The research, published in the American Journal of Infection Control (AJIC), was performed in the 26-bed medical intensive care unit of a 600-bed Wisconsin hospital. It found that, of samples tested, 87% of the unit’s patient sinks next to toilets tested positive for Klebsiella pneumoniae carbapenemase (KPC) while only about 22% of sink drains located closer to the entry door of the room tested positive for KPC.

Furthermore, researchers found that in four of five rooms in which the entry-door sink tested positive, the sink near the toilet was also positive. This, the researchers suggest, points to a potential source for in-room cross-contamination.  

In the news release, the study authors are quoted as saying, "This study, if validated, could have major implications for infection control. If sinks next to toilets are indeed a reservoir for KPC, additional interventions — such as modified hand hygiene practices and sink disinfection protocols — may be needed to stem the risk of transmission among healthcare providers and patients alike."

Despite the high presence of KPC in the hospital's medical intensive care unit, the release noted that the unit did not have any documented interactions with KPC-producing organisms within the past year.

Influenza Activity Hits Seasonal High; 28 Pediatric Deaths Recorded

Influenza-like illness (ILI) has reached its highest mark this flu season, according to the latest FluView report from the Centers for Disease Control and Prevention (CDC).

For the week ending February 2, the proportion of people seeing their healthcare provider for ILI reached 4.3%. That's an increase over the previous week (3.8%). It is also above the national baseline of 2.2%, but substantially lower than the 7.5% peak recorded last season. The national percentage of patient visits to healthcare providers for ILI reported each week is calculated by combining state-specific data weighted by state population.

Unfortunately, the latest report brought the news of four new flu-related pediatric deaths, bringing the total to 28 flu-related deaths in children for the 2018-2019 flu season.

H1N1 viruses have been the most commonly identified flu viruses nationally, but H3N2 viruses have predominated in the southeastern region of the United States.

CDC stated it expects flu activity to remain elevated for a number of weeks and advised anyone 6 months or older who has not yet been vaccinated this season to get vaccinated as soon as possible.

January 2019 Issue of Infection Prevention & Control Newsletter Published

The January 2019 issue of the ICCS Infection Prevention & Control Newsletter has published.

The issue includes tips on skip prep, peel pouches and enzymatic detergents and reports on innovations, AORN guidelines changes, virtual tool for cancer patients, dangers of infection during delivery and antibiotic resistance.

Access the latest issue of our infection prevention newsletter.

Receive the free ICCS Newsletter by signing up here.